3:00pm - 3:15pm (CDT) | 2086.0 - Strategies for increasing acceptability of harm reduction practices in rural Missouri

Session: Examining the Intersections of Rurality, Stigma, and Discrimination

Program: Mental Health

Presenter: Zach Lynch, MSW, MPA, MPH, SUDP

Authors:

Debbie Humphries, PhD, MPH, MA

Nithya Narayanan, MPH

Robert Heimer, PhD

Katie Wang, PhD

Abstract

Introduction

Despite a nationwide syndemic of substance use, overdose, and HIV infection and the availability of evidence-based harm reduction (HR) treatment and prevention practices, HR practices are inconsistently applied. Rural communities present distinct cultures, with unique strengths for and obstacles to addressing the syndemic. Our objective was to characterize and understand HR as a first step in developing innovative approaches for diffusing harm reduction in rural Missouri.
Methods: We conducted interviews with people with lived experience of substance use (n=16), providers or staff of FQHCs or rural health centers (n=15), regional leaders (n=5) and community advocates (n=5) residing in rural Missouri. Interview topics covered HR practices, perceptions of stigma and syndemic roots, and experiences with diffusion of innovation. Texts were analyzed using a rapid qualitative analysis approach to characterize understanding of HR and identify potential interventions to expand HR options.

Results

Participants provided multiple definitions of HR: the “absence of biases,” a simple listing of HR practices, offering help “regardless of history” or “stuff to do your dope with so you don’t hurt yourself”. Buy-in from local leaders and health administrators was identified as essential for increasing HR services. Creative approaches to increasing acceptability of HR included integration of messaging and resource dissemination into unrelated, “day-to-day” circumstances, small businesses serving as hubs for HR conversations, door-to-door engagement, and hosting prosocial recovery celebrations.

Discussion

Results from this study will inform future work to reimagine strategies in health communication, collaboration, and advocacy to promote innovation in pursuit of expanding HR services.